A Visualized Dynamic Prediction Model for Lymphatic Metastasis in Ewing's Sarcoma for Smart Medical Services

Frontiers in Public Health

article

Wenle Li¹  Chan Xu²  Zhaohui Hu³  Shengtao Dong⁴  Haosheng Wang⁵  Qiang Liu¹  Zhi-Ri Tang⁶  Wanying Li²  Bing Wang²  Zhi Lei⁷  Chengliang Yin⁸ 

[1] Department of Orthopedics, Xianyang Central Hospital;Clinical Medical Research Center, Xianyang Central Hospital;Department of Spinal Surgery, Liuzhou People's Hospital;Department of Spine Surgery, Second Affiliated Hospital of Dalian Medical University;Department of Orthopaedics, The Second Hospital of Jilin University;School of Physics and Technology, Wuhan University;Chronic Disease Division, Luzhou Center for Disease Control and Prevention;Faculty of Medicine, Macau University of Science and Technology

关键词: Ewing's sarcoma (ES);    SEER database;    multicenter data;    nomogram;    web calculator;   

DOI  :  10.3389/fpubh.2022.877736

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background This study aims to predict the lymphatic metastasis in Ewing's sarcoma (ES) patients by nomogram. The risk of lymphatic metastasis in patients with ES was predicted by the built model, which provided guidance for the clinical diagnosis and treatment planning. Methods A total of 929 patients diagnosed with ES were enrolled from the year of 2010 to 2016 in the Surveillance, Epidemiology, and End Results (SEER) database. The nomogram was established to determine predictive factors of lymphatic metastasis according to univariate and multivariate logistic regression analysis. The validation of the model performed using multicenter data ( n = 51). Receiver operating characteristics (ROC) curves and calibration plots were used to evaluate the prediction accuracy of the nomogram. Decision curve analysis (DCA) was implemented to illustrate the practicability of the nomogram clinical application. Based on the nomogram, we established a web calculator to visualize the risk of lymphatic metastases. We further plotted Kaplan-Meier overall survival (OS) curves to compare the survival time of patients with and without lymphatic metastasis. Results In this study, the nomogram was established based on six significant factors (survival time, race, T stage, M stage, surgery, and lung metastasis), which were identified for lymphatic metastasis in ES patients. The model showed significant diagnostic accuracy with the value of the area under the curve (AUC) was 0.743 (95%CI: 0.714–0.771) for SEER internal validation and 0.763 (95%CI: 0.623–0.871) for multicenter data external validation. The calibration plot and DCA indicated that the model had vital clinical application value. Conclusion In this study, we constructed and developed a nomogram with risk factors to predict lymphatic metastasis in ES patients and validated accuracy of itself. We found T stage (Tx OR = 2.540, 95%CI = 1.433–4.503, P < 0.01), M stage (M1, OR = 2.061, 95%CI = 1.189–3.573, P < 0.05) and survival time (OR = 0.982, 95%CI = 0.972–0.992, P < 0.001) were important independent factors for lymphatic metastasis in ES patients. Furthermore, survival time in patients with lymphatic metastasis or unclear situation ( P < 0.0001) was significantly lower. It can help clinicians make better decisions to provide more accurate prognosis and treatment for ES patients.

【 授权许可】

CC BY